Dr. Susan Bressler talks about two new medications for age-related macular degeneration – Avastin and Lucentis.
Q. I’ve heard that new medications to treat wet age-related macular degeneration (AMD) are available. Are these new medications better than current treatments?
A. Two new medications—Avastin (bevacizumab) and Lucentis (ranibizumab) -- are now in use to treat macular degeneration. These new macular degeneration treatments are exciting because they offer the opportunity to slow vision loss and may restore vision, to a degree, in some people with wet macular degeneration. Older drugs for wet macular degeneration, like Macugen (pegaptanib), also offer the possibility of decreasing further vision loss but rarely lead to the restoration of vision.
Both new wet macular degeneration medications inhibit angiogenesis—the process by which the body creates new blood vessels. Wet macular degeneration is caused by the abnormal growth of blood vessels below the retina. These fragile vessels often burst, and blood, fluid, and the vessels themselves cause damage to the eye.
Avastin was approved by the FDA in 2004 for intravenous administration to treat colon cancer, but many ophthalmologists found that very small doses of it injected into the eye appeared effective against wet macular degeneration. Genentech, the company that produces Avastin, tested and reformulated the drug as a specific treatment for wet macular degeneration. The result is Lucentis, which was FDA approved for wet macular degeneration in June 2006.
Genentech claims the newer macular degeneration drug can more easily pass through the retina, but perhaps the biggest difference between the two Genentech drugs is their cost—a dose of Avastin for wet macular degeneration costs from $30–$200, while treatment with Lucentis can cost thousands of dollars. Medicare covers Lucentis, but it still may cost more than Avastin depending on your particular prescription plan.
Neither macular degeneration medication has a very long track record, so which one is the best choice? According to ophthalmologist Susan Bressler, MD., the Julia G. Levy, Ph.D., Professor of Ophthalmology at Johns Hopkins University School of Medicine, "The advantage of Lucentis is that its safety and efficacy in people with wet macular degeneration have been more firmly established than those of Avastin.” However, Dr. Bressler adds, “I would recommend Avastin for many individuals who have wet macular degeneration and cannot afford to receive Lucentis.” In 2007 the National Institutes of Health will begin ahead-to-head test of the two drugs.
According to Dr. Bressler, "Among the available treatment options, these two medications offer the greatest chance of stabilization or recovery of vision for wet macular degeneration patients.”
